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The Anatomical Concave Surface Area Method, a 3-Dimensional Quantification of Glenoid Bone Loss in Shoulder Instability

The Anatomical Concave Surface Area Method, a 3-Dimensional Quantification of Glenoid Bone Loss in Shoulder Instability

Marine Launay, MEng, AUSTRALIA Muhammad Naghman Choudhry, MBChB, MRCS, FRCS, AUSTRALIA Nicholas Green, MEng, BDes, AUSTRALIA Jashint Maharaj, MBBS, FRSPH, AUSTRALIA Peter Pivonka, PhD, AUSTRALIA Kenneth Cutbush, MBBS, FRACS, FAOrthA, AUSTRALIA Ashish Gupta, MBBS, MSc, FRACS, AUSTRALIA

Shoulder Surgery QLD Reserach Institute, Brisbane, QLD, AUSTRALIA


2021 Congress   Abstract Presentation   5 minutes   Not yet rated

 

Anatomic Location

Diagnosis / Condition

Diagnosis Method

Sports Medicine

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Summary: The ACSA method uses a 3-Dimensional area-based quantification accounting for the concavity of the glenoid fossa to estimate instability-related glenoid bone loss.


Background

Recurrent shoulder instability may be associated with glenoid erosion and bone loss. Quantification of glenoid bone loss influences surgical procedure contemplated and preoperative planning of stabilisation procedures.

Purpose

This study aimed to quantify the concave surface area of glenoid bone loss, utilizing 3-Dimensional (3D) segmented models of the scapula. Comparisons with methods utilizing the glenoid rim for bone loss estimations (best circle fit method and glenoid height/width method) were also investigated.

Methods

36 consecutive preoperative bilateral Computed Tomography (CT) scans of patients eligible for primary stabilization procedure were selected from our institutional surgical database (mean age 29 ± 9 years, 31 males and 5 females). Bilateral CT scan segmentation allowed for generation of 3D models of both scapulae. The Anatomical Concave Surface Area (ACSA) of the inferior glenoid was mapped using the diameter of the best-fit circle of the healthy glenoid using 3-Matic 13.0 software (Materialise, Leuven, Belgium). A ratio of the difference between surface areas of both glenoids (healthy and pathological) against the anatomical circular surface area of the healthy glenoid (ACSA method) was calculated to estimate bone loss. These results were compared with glenoid bone loss estimations obtained using the best circle fit and glenoid height/width methods. Inter- and intra-observer reliabilities were also calculated.

Results

The average bone loss calculated using the ACSA, best circle fit and glenoid height/width methods were 9.4 ± 6.7%, 14.3 ± 6.8% and 17.6 ± 7.2% respectively. The ACSA method showed excellent inter-observer reliability with Intraclass Correlation Coefficient (ICC) of 0.95 compared to the best circle fit (ICC = 0.71) and glenoid height/width (ICC = 0.79) methods.

Conclusion

This study showed that use of 3D anatomical concave surface area method to quantify instability-related glenoid bone loss is reliable and provides results that are less than methods utilizing the glenoid rim for bone loss estimations.


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